Insight

ABA therapy M&A overview

KPMG Corporate Finance LLC’s 2019 healthcare practice year in review

Walter Olshanski

Walter Olshanski

Managing Director, KPMG Corporate Finance LLC

+1 646-874-4878

 

U.S. ABA therapy market overview

Increased incidence of autism spectrum disorder and favorable legislative reforms present major growth opportunities for the autism services market in the U.S

  • Autism spectrum disorder (“ASD”) refers to a range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication.
  • The autism services market is estimated to generate approximately $5 – $7 billion in revenue annually.1
  • The rising prevalence of ASD can largely be attributed to improvements in monitoring, screening, and diagnosis of the condition.
  • The total annual direct medical, direct non-medical and productivity costs combined for treating ASD was estimated to be approximately $268 billion for 2015.2
  • In the absence of more-effective interventions and lifelong support for those with ASD, the cost is estimated to rise to $461 billion by 2025.2
  • On average, it costs around $60,000 a year to care for someone with autism.2
  • As of October 2019, all 50 states have taken action to require meaningful coverage for the treatment of autism in state-regulated health plans.3
  • Rising awareness about the benefits of early intervention and intensive therapy has spurred the expansion of insurance coverage.
  • Owing to the rising number of children diagnosed with disabilities, strong federal funding levels, mandatory coverage private insurers, demand for the providers of the services is expected to remain high.

 

U.S. ABA therapy market overview

Autism services continues to experience economic tailwinds driving significant consolidation activity.

  • The autism spectrum disorder treatment market in the U.S. is highly fragmented, and is primarily served by small, independent school-based and community-based players with local or regional presence.
  • The ABA market in the U.S. is serviced by approximately 30,000 board certified behavior analysts and it is estimated the workforce would need to be doubled to meet current ASD service needs.1
  • The favorable reimbursement environment, increased incidence levels, and heavy fragmentation within the sector, are primary factors driving investment within the sector.
  • Going forward, a healthy amount of M&A activity is expected to continue within the sector as smaller independent programs continue to be acquired by larger well capitalized market consolidators.
  • Consolidation is expected to be driven by private equity groups not yet invested in the space, PE-backed consolidators, and general behavioral health consolidators with autism service offerings.

ABA therapy M&A activity2


Key factors driving consolidation activity in the sector

Highly fragmented market

The market is highly fragmented with most enterprises operating on a local or regional basis, thus creating an environment ripe for consolidation.

Favourable macro trends

The rising demand for services from increasing prevalence of ASD and other developmental disorders presents significant opportunity for growth.

Multiple growth strategies

Size advantages help investors better negotiate rates with payors, recruit additional providers, and build a strong brand presence.

Favourable regulatory environment

Expanded commercial coverage for autism services across states and ongoing reforms make the sector attractive to investors.

 

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Footnotes

1Forbes Investor Overview: Autism Services (December 2018)

2Autism and Health: A special report by Autism Speaks (2017)

3Autism Speaks: State Regulated Health Benefit Plans

4Center for Disease Control and Prevention

 

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KPMG Corporate Finance LLC’s investment bankers have extensive Healthcare transaction and industry experience, which enables them to understand the industry-specific issues and challenges facing our clients.